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Atypical macular hole formation after Anti-VEGF therapy for neovascular age-related macular degeneration: Coincidence or consequence?

Authors
  • Kayaarasi Ozturker, Z1
  • Akca Bayar, S2
  • Yaman Pinarci, E3
  • Kurt, R A3
  • Akkoyun, I2
  • Yilmaz, G2
  • 1 Baskent University, Faculty of Medicine, Department of Ophthalmology, Istanbul Hospital, Estambul, Turquía. Electronic address: [email protected]
  • 2 Baskent University, Faculty of Medicine, Department of Ophthalmology, Ankara Hospital, Ankara, Turquía.
  • 3 Baskent University, Faculty of Medicine, Department of Ophthalmology, Istanbul Hospital, Estambul, Turquía.
Type
Published Article
Journal
Archivos de la Sociedad Espanola de Oftalmologia
Publication Date
Sep 01, 2021
Volume
96
Issue
9
Pages
455–461
Identifiers
DOI: 10.1016/j.oftal.2020.08.011
PMID: 33454162
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

Age-related macular degeneration (AMD) is the primary cause of blindness in developed countries, particularly in older adults. Anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection is the current standard treatment for neovascular form of AMD. Studies reporting macular hole (MH) formation following anti-VEGF treatment are limited, and the exact pathogenesis is still under discussion. With the present study, we aim to analyse the clinical features of eyes developing MH after anti-VEGF therapy for neovascular AMD. Patients were treated with intravitreal anti-VEGF agents for at least one year and stable for at least six months. Best-corrected visual acuity (BCVA) and optical coherence tomography findings were evaluated. Nineteen eyes of 18 patients were included in this study. Patients had an average age of 77.7 years at first visit and eight were female. The average number of injections before the MH formation was four. MH developed after a mean follow-up of 5.1 months after the last injection. Sixteen eyes had (84.2%) had choroidal neovascular membrane without any abnormal vitreomacular traction. Eleven eyes (57.8%) had retinal pigment epithelium detachment (PED), two (10.5%) had an epiretinal membrane (ERM), and one (5.2%) had retinal pigment epithelium (RPE) tear. The mean first and last BCVA was 1.07 ± 0.48 LogMAR (0.3-1.8) and 1.16 ± 0.38 logMAR (0.4-1.8), respectively. A macular hole can be observed in AMD patients receiving anti-VEGF therapy. Increased fibrovascular scar tissue due to subretinal fluid resolution, neovascular membrane contraction, and the presence of PED, RPE tear, and ERM may contribute to MH formation. Copyright © 2020 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

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